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Prognostic impact of positive lymph node ratio in gastric carcinoma
Orhan Celen1, Emin Yildirim, Uğur Berberoglu
1Ankara Oncology Research and Training Hospital, Department of General Surgery, Turkey. drorhancelen@yahoo.com
Background And Objectives:
To evaluate the prognostic value of metastatic lymph node ratio in gastric carcinoma.
Methods:
One hundred and sixty four patients who underwent D(2) dissection for gastric carcinoma at Ankara Oncology Hospital were reviewed retrospectively. The prognostic factors including Japanese classification, AJCC/UICC TNM classification and metastatic lymph node ratio (1-10% and >10%) were evaluated in univariate and multivariate Cox regression analysis.
Results:
The multivariate analysis showed that Borrmann classification, pN-category of AJCC/UICC classification and metastatic lymph node ratio were the most significant prognostic factors and a higher hazard ratio was obtained for metastatic lymph node ratio than pN category of AJCC/UICC classification (4.5 vs. 11.4). When the metastatic ratio groups of 1-10% and >10% were subdivided into pN(1), pN(2) and pN(3) categories of the AJCC/UICC classification, there was no statistical difference between survival curves. When pN(1), pN(2) and pN(3) categories of the AJCC/UICC classification were subdivided into the ratio groups of 1-10% and >10%, the survival rate of ratio group 1-10% was better than ratio group >10%.
Conclusion:
With its simplicity and reproducibility, metastatic lymph node ratio can be used as a reliable prognostic indicator.